Quality of life experience in physically frail people on renal dialysis: A qualitative meta-synthesis on the difficulties and resources for better health care.
Anabel Ramírez-García, Alba Torné-Ruiz, Aida Bonet and 3 others
PMID 40786854WHAT IT FOUND
Dialysis patients described frailty as limiting daily activity, increasing fall risk, and stripping work, family, and social roles.
They also said teams underestimated falls, while family, peers, and exercise programs were reported as supports.
Key findings
01Frailty and dialysis were associated with low tolerance for daily activities, fatigue, pain, weakness, fear of worsening, misinformation, normalized functional decline, and increased fall risk.
02Dialysis time, dependence, comorbidities, and financial strain were linked to loss of family, work, and recreational roles, while family, close people, and fellow patients supported treatment adherence and emotional safety.
03Participants reported that healthcare teams underestimated falls and physical activity, needed clearer communication, and valued person-centered care, peer exercise, and coordinated services.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
Frailty was hard to define, and some studies included patients with or without a clinical frailty diagnosis, so the group may not be uniform. Only English and Spanish studies published from 2013 onward were searched, so experiences from other languages, settings, and older literature may be missing. Home hemodialysis, transplant recipients, end-of-life care, and professional or family perceptions were excluded, so the findings may not apply to those patients or to caregiver views. Some included studies were rated medium quality, with issues such as unspecified design, a single participant, or incomplete meaning units. Cultural and geographic differences were not fully considered, so themes may not transfer to all countries or health systems.
Declared interests
The authors declare there is no conflict of interest.
The easy way to misread this
Do not treat the suggested exercise, education, or person-centered programs as proven to improve quality of life or prevent falls. This paper synthesizes patients' experiences, not tested interventions.